Steve Moody, director of nursing at Central Maine Medical Center, enters a tent outside the emergency entrance to the hospital to test patients who have symptoms of the coronavirus, Friday, March 13, 2020, in Lewiston, Maine. Credit: Robert F. Bukaty | AP

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Coronavirus-related hospitalizations in Maine surged over the weekend, with the number of patients hospitalized statewide returning to mid-April levels as the state prepares to continue removing business restrictions in the coming week.

The increase was largest in the Portland area, according to Nirav Shah, the director of the Maine Center for Disease Control and Prevention, who said it was fueled by outbreaks at long-term care facilities.

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

The total number of patients currently hospitalized with the virus rose to 60 on Tuesday, nearly tying the high mark set on April 13. Since the Maine CDC began releasing data on daily coronavirus hospitalizations in early April, numbers had generally declined, hitting as few as 32 patients hospitalized on April 29 before surging in the past week.

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The 10 new hospitalizations on Sunday was the second-largest single day jump since the outbreak began in mid-March. The 60 patients hospitalized on Tuesday represent a 36 percent increase from one week earlier.

The uptick was greatest in the Portland area, with the outbreak at the Cape Memory Center in Cape Elizabeth accounting for a significant portion of the new hospitalizations, Shah said Tuesday. Forty-seven residents of the long-term care facility for individuals with Alzheimer’s diseases or dementia have tested positive for the virus, as have 20 staff members. One individual “associated with the center” has died, he said.

There have been outbreaks at nearly a dozen long-term care facilities in Maine, though two of the facilities with the largest outbreaks — at The Commons at Tall Pines in Belfast and the Augusta Rehabilitation Center — no longer have any active cases.

Community transmission in the Portland area also accounted for part of the increase in hospitalizations over the weekend, Shah said. Cumberland County is one of four where community transmission has been identified.

Maine Medical Center in Portland had 31 coronavirus patients as of Tuesday, up from 17 a week earlier, according to data provided by MaineHealth, the hospital’s parent organization. That figure was down, however, from Monday, when 35 coronavirus hospitalizations were reported at the state’s largest hospital, its highest total since April 7.

Hospitalization data is considered to be one signal of the prevalence of the coronavirus regardless of the level of testing. However, an increase in hospitalizations driven by outbreaks in long-term care facilities, which have been on lockdown since mid-March, would not necessarily indicate that the disease is widespread in the overall population.

Tuesday Hospitalizations could be a “great indicator” of the severity of the outbreak, Shah said, though he cautioned that they also lag since people who are hospitalized contracted the disease days, or even weeks, earlier.

“Individuals that need to go to the hospital are among the sickest of all people with COVID-19,” he said. “That being said, it remains a small fraction of the overall number of active cases.”

As of Tuesday, there were 2,109 confirmed or probable coronavirus cases in Maine, including 712 active cases. Seventy-nine Maine residents have died from the virus.

The increase in hospitalizations comes as Maine continues to reduce restrictions on economic activities. Private campgrounds were permitted to open for Memorial Day weekend. Retail outlets and restaurants were recently allowed to open in 12 mostly rural counties and will be able to open statewide on June 1 under public health precautions.

The state will assess its reopening plans “shortly” looking at several data points, including testing and the positivity rate, Jeanne Lambrew, commissioner of the Maine Department of Health and Human Services, said.

Maine has substantially increased coronavirus testing in the past few weeks, with the state announcing last Monday that anyone could get a test with a doctor’s order. Previously, testing had largely been reserved for health care workers and vulnerable populations.

As of last Wednesday, more than 40,600 coronavirus tests had been performed, though some individuals have been tested more than once. The positivity rate — the percentage of tests to come back positive — sat at 5.5 percent, according to the Maine CDC. The agency updates data on testing and the positivity rate weekly on Wednesdays.

Watch: Should you remove loved ones from care facilities during the outbreak?

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